Anne Mutta, is Multi-Country Programme Manger for Sustainable Hygiene and Sanitation for all project. The project addresses rural sanitation, and is implemented across six countries in Africa and Nepal. Sub-Saharan Africa countries such as Ethiopia, Kenya, Mozambique, Uganda, Tanzania, Zambia and Nepal in Asia are benefiting from the programme. Anne, who is based in Kenya, has 20 solid years experience leading action-oriented and evidence-baset WASH programme.
The Ethiopian Herald recently spend some time with her to know what is going on in terms of hygiene and sanitation. Excerpts:-
The Herald: How do you see African countries in terms of hygiene and sanitation? What do you observe in this regard ?
If you look at the recent data that is braced annually by World Health Organization, UNCEF, the progress is varied. Within the Sub-Saharan African countries, there is almost uniform progress. The rate may differ by three or four percent. The big issue here is open defecation is reducing, but the move to basic sanitation is still far off. Simply, we are off target. And it is likely that most countries again would not meet the SDG target of universal access to basic sanitation by 2030. It is a crisis.
The progress is slow, or it is moving fast depending on the country and the support it gained from the government. Various partner are willing to create access to toilet. However, access to hand washing facilities still remains a challenge. The issue of sharing latrine is a cultural issue for many African countries. So first, making pastoral communities aware to not share latrine is hard. Thus, the cultural issue may affect the uptake of latrine. By and large, the over all progress is very slow across these countries.
The Herald: What are the reasons for this [culture affecting the uptake of latrine]?
There are many reasons for this. Some of the reasons has to do with the community’s perspective, and the government’s. Primarily, still sanitation is not prioritized. Most of the governments [in Africa] are not investing in water sanitation and hygiene.
They simply work for political gain. If you do water project, it is more visible than promoting sanitation and hygiene, which is at the gatehouse level. If you look at the community’s side, the struggle is with technologies. If you do not have sandy soil, it is very hard to find the appropriate technologies for such people.
We have issues related to access to the market for sanitation products. Running sanitation as a business remains low. If the distance between the household and the sanitation spot is too long, the cost goes up. The issues with regards to the government, especially at local level, not only relates to prioritizing sanitation, but also to not having the human resource that is capable enough to handle sanitation. So, you have many actors perhaps working in small areas, or sanitation budgets spread across many ministries or departments. As a result, the budget becomes minimal, and should be adjusted according to the cost of operation. The challenges surrounding awareness creation revolves around budget constraints, which in the first place is funded by donors.
The Herald: What damages does the absence of hygiene and sanitation bring?
Due to absence of hygiene and sanitation, African countries are exposed to water born diseases such as diarrhea, cholera during the rainy season. That is the result of open-defecation. If we look at typhoid, Guinea worm, they are caused by poor sanitation. Open-defecation, waste disposal practices all lead to contamination of water resources. Since people are not able to go to work, or work on their farm and generate income once they are sick, there will be a loss on the economic and productivity side of the household. Not to mention, there is also government expenditure allocated to prevent these diseases while it could have been used for other pressing issues.
The Herald: How many people die due to hygiene and sanitation caused diseases?
I do not have the number in my hand. It varies from country to country. But, we say globally one out of every three people are affected by poor sanitation. I think the number gets high in Africa given the luck of access to clean water. It could be more than three people. At least four out of ten people gets affected by poor sanitation, which is easily preventable in the first place.
It is very simple; have the people in those places possess latrine, enable them to use it correctly and maintain them. Through this alone, you can eliminate almost forty percent of the health budget being spent on treating the patients.
The Herald: So how do you evaluate the commitment of the governments in those six countries?
The commitment, I cannot measure. From financial perspective, less than ten percent of budgets is spent on sanitation. If it is a priority, it should get more resource allocation. if you look at it from implementation perspective, a very little budget has been funneled to the lower districts from the center. Very little budget is spent on sanitation.
And second, it is very hard to find champions of people who can advocate for sanitation due to the low level of investment. If you have champions, you will be able to push most of these things and get the government to respond to it. I say the commitment is not high because there is shortage of money, lack of role models and actual plans to eradicate poor sanitation.
The Herald: Now let me come to your country Kenya, I think there is better achievement there. What can other countries can learn from that?
Of course, there is always a winner when you compare countries or individuals. But, it doesn’t mean anything.
If you look at the capacity of the country [Kenya], looking at the level of policies that we have at the national level, looking at the budget at the national level, we can and should do much better. So, I would not want to compare, because I know the comparison gives us different perspective. But, the progress that we have made can be accelerated much more if you could allocate more investment, and have competent professionals and policies at the national that you can roll it down to household level.
Of course, when you look at the national data, you can see that we are doing well. However, when we segregate the data in terms of zones or regions, we can see disparities. So, some zones, regions do much better than others.
You could also see that the level of investment also vary. Again, if you look at just the groups of people who are making progress, you would find that there is still a big challenge facing very poor, female-led households, people living with disability, people living at inaccessible areas or people who do not have access to technology. And due to cultural practice and living conditions, pastoral communities have limited access to water.
The Herald: Is there any best practice that your country can share for the rest of African countries?
I think all countries can share good practice between them. It really depend on what the issues are. In terms of policy, regulations, Kenya has very good experience. Also, in terms of having a reach, we are doing much better the others. Yes, we also have very good documentation in terms of what needs to be done, how it can be done and what should be monitored. And I think a few countries are struggling about regulations and policy. But the challenge remains in implementation. To this end, we are working on how we can better our capacity to implement policies and regulations.
For instance, number of villages in this case have been declared defecation-free. However, given that we have the lowest unit of service delivery, our focus of intervention is confined to very small units. We can hardly give you more than ten district that are defecation-free. So, I am hoping that now the push for SDG can help us increase it to higher level and be able to work at district (Kebele or Woreda) level.
The Herald: You had the chance to visit the six African countries that SNV project has been implemented upon. How do you evaluate the status/state of countries in this regard?
I have seen progress. But the progress varies depending on the countries. The progress has been very high at countries with very high open-defecation rate. For countries that have already tackled the issue of open-defecation, the challenge is about moving or improving from basic to latrine. Country with 20 percent of open-defecation have been able to make significant stride in 2018, by raising it to 60-70 per cent.
Some countries are struggling to push for higher coverage, because while I think the bulk of the population have some idea about open-defecation and defecation free environment, the issue lies on how to translate that knowledge into building durable facilities that can perhaps last longer. So, progress is high, and sustaining progress is the challenge moving ahead facing all countries. Open-defecation is reducing significantly across the country at rural areas; urban areas have their own challenges.
The Herald: As a professional, what do you advise African countries to come out of these problem?
I do not think spending a lot of money in rural sanitation is the way to go. I think that money should be going to more developmental activities. Urban sanitation just needs a campaign that all of us can commit to and take responsibility for to push. I do not think suffering from diarrhea, cholera should even happen in our cities. The fact that we still had cholera cases in 2018 is an embarrassment. Africa is rising; and Africa can also rise in sanitation order. It should be a discussion point.
The Herald: Thank you very much Anne
Its my pleasure.
Herald December 20/2018
BY GIRMACHEW GASHAW
